How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $29.51 | Facility | None | $21.88 | $21.88 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $21.88 Typical High $21.88 | Professional | None | $3.63 | $21.88 | $21.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $10.23 Median $12.30 Typical High $15.14 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.23 | $12.30 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $1.95 Median $32.36 Typical High $3,162.28 | Facility | None | $1.95 | $32.36 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $12.59 Typical High $125.89 | Professional | None | $7.76 | $12.59 | $125.89 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $275.42 | Facility | None | $199.53 | $204.17 | $275.42 |
United Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $19.50 | Professional | None | $8.13 | $12.30 | $19.50 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 52 · Reduced service | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.57 |
Where Alabama sits
The same service costs 11.2 times more in Texas than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alabama· 15th of 51
$29.51
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.